Advanced Hybrid Closed-Loop System Achieves and Maintains Recommended Time in Range Levels for Up To 2 Years: Predictors of Best Efficacy
Authors' conclusion
Switching to an AHCL leads to a rapid improvement in glycemic control lasting for up to 24 months along with a low risk for hypoglycemia, confirming the safety of the system. Lower baseline HbA1c was the main predictor of better efficacy of therapy, although higher baseline HbA1c was associated with the greatest improvement in mean TIR.
Study context
- Population
- Adults with T1D using the MiniMed 780G; mean age 42.8 ± 16.5 years, men 42.9%, diabetes duration 22.5 ± 12.8 years, BMI 24.9 ± 4.7 kg/m², baseline HbA1c 63.4 ± 12.2 mmol/mol (8.0 ± 1.1%)
- Participants
- 296 adults
- Exposure
- Advanced hybrid closed-loop (AHCL) vs 4 weeks before switch
- AHCLn = 296
- Outcome
- Long-term efficacy of AHCL (CGM-derived metrics and insulin requirement)
- Follow-up
- Up to 2 years
Methodological detailssingle-group, pre-post comparison
- Single-group
- Pre-post comparison
Main finding
As reported in the abstract
TIR · first quarter of AHCL treatment vs 4 weeks before switch
Time in range (TIR) increased from baseline to first quarter of AHCL (P < 0.0001)
58.1 ± 17.5% to 70.3 ± 9.5%
Observational data: associations, not effects.
Further findings
Targets achieved throughout observation · up to 2 years
- Mean TIR >70%
- 53.4%
- Mean TBR <4%
- 92.6%
- Mean GMI <53 mmol/mol (7.0%)
- 46%
Predictors of mean TIR >70%
- Univariable logistic regression: older age, lower baseline HbA1c and insulin requirement associated with mean TIR >70%
- Multivariable: lower HbA1c remained independently associated with better glycemic control
- Mean TIR increased more with higher baseline HbA1c
Safety
Time below range · throughout observation
- Participants achieving mean TBR <4%
- 92.6%
Original publication
Advanced Hybrid Closed-Loop System Achieves and Maintains Recommended Time in Range Levels for Up To 2 Years: Predictors of Best Efficacy. Diabetes Technol Ther. Published 8 November 2023. doi:10.
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